Improving Patient Care Through Objective Monitoring of At-Home Repetitive Ritual Behaviors in Obsessive-Compulsive Disorder

项目摘要 强迫症（OCD）的特征是侵入性的，令人痛苦的想法（强迫症）， 一个人感到被迫执行重复行为（强迫）的反应， 进行，以减少病人经历的急性痛苦，但这使强迫症永久化 症状有效的治疗需要准确报告强迫行为，一个关键的挑战是， 病人经常向他们的提供者报告他们的行为，因为短期的焦虑缓解带来了 通过参与强制性的行为比长期抵抗强制性的挑战更可取， 治疗病症，从而削弱这些治疗的功效。现有的客观监测工具， 例如心电图（ECG）监视器，可以检测焦虑增加的时期，而腕戴式设备 可以监测拉头发等行为，但检测洗手的准确性有限 强迫症中常见，因此不适用于这些患者。总目标 第一阶段STTR的目标是通过开发和测试技术的可行性来解决这一关键差距， 创新涉及一种新型的可穿戴智能环记录模式，这种模式是非侵入性的， 强迫行为的客观测量，以明显改善患者和他们的治疗师 强迫症治疗的有效性该戒指设备提供了几个创新：它是一个智能戒指（1），可以 检测清洁剂，如水或酒精（2）以及重复行为（3），以便客观地监测 强迫性洗手或其他仪式活动（4）。该信息将被发送到仪表板（5）， 治疗师的实时日志，以客观地测量戒指检测到的行为数量并监测佩戴情况- 时间依从性（6）。本建议的具体目标是：1）优化可接受性，可行性和效用， 戒指设备及其相关的智能手机应用程序/网络界面，通过迭代1：1反馈，从范围 这项技术的用户（患者/提供者）; 2）开发一个原型活动记录智能环， 相关软件系统的基础上，目标1的调查结果。智能戒指将是一个微型系统， 运动、温度和湿度。它将记录，而磨损和无线下载数据，与一个配对， 智能手机应用程序，将与云存储模式同步; 3）进行多阶段的可接受性， 可行性和实验评估方案首先与健康成人，然后与强迫症患者， 随后与临床医生进行深入的反馈访谈。先进的医疗电子产品具有广泛的 在生物医学发展方面的经验，学术合作伙伴（Asnaani，Gooneratne）在强迫症方面具有专业知识， 实验方法，mHealth，生物医学创业，沿着成功的先前记录， 在以前的STTR资助的研究和建议的合作。如果成功，该项目将为患者提供 和卫生保健提供者提供一个非侵入性和更准确的工具，实时监测典型的 强迫行为，以明显提高强迫症一线治疗的疗效。

Project Summary Obsessive-compulsive disorder (OCD) is characterized by intrusive, distressing thoughts (obsessions) in response to which an individual feels compelled to perform a repetitive behavior (compulsions), which are performed in order to reduce the acute distress experienced by the patient but which perpetuate OCD symptoms. Effective treatment requires accurate reporting of compulsive behaviors, and a key challenge is that patients often underreport their behaviors to their providers because the short-term anxiety relief brought about by engaging in the compulsion is preferable to the long-term challenge of resisting the compulsions in order to treat the condition, thereby impairing the efficacy of these treatments. Available objective monitoring tools, such as electrocardiogram (ECG) monitors, can detect periods of increased anxiety, while wrist-worn devices can monitor behaviors such as hair pulling, but they have limited accuracy for detecting hand-washing compulsions which are common in OCD and are thus not indicated for use in these patients. The overall goals of this Phase 1 STTR are to address this key gap by developing and testing the feasibility of a technological innovation involving a novel wearable smart-ring recording modality that is unintrusive and provides a more objective measure of compulsive behavior to both patients and their therapists in order to appreciably improve the effectiveness of OCD treatment. This ring device offers several innovations: It is a smart ring (1) that can detect cleaning agents like water or alcohol (2) as well as repetitive behaviors (3) in order to objectively monitor obsessive hand-washing or other ritualistic events (4). This information would be sent to a dashboard (5) with a real-time log for a therapist to objectively measure the number of behaviors the ring detects and monitor wear- time compliance (6). Specific aims of this proposal are to: 1) Optimize acceptability, feasibility and utility of the ring device and its associated smartphone app/web interface through iterative 1:1 feedback from the range of users of this technology (patients/providers); 2) Develop a prototype activity recording smart ring and associated software system based on Aim 1 findings. The smart ring will be a miniature system that records movement, temperature, and wetness. It will record while worn and wirelessly download data, pairing with a smartphone app which will sync with a cloud storage modality; 3) Conduct a multi-phased acceptability, feasibility and experimental assessment protocol first with healthy adults and then with patients with OCD, followed by in-depth feedback interviews with clinicians. Advanced Medical Electronics has extensive experience in biomedical development, and academic partners (Asnaani, Gooneratne) have expertise in OCD, experimental methodology, mHealth, biomedical entrepreneurship, along with a prior track record of successful collaboration on previous STTR funded studies and proposals. If successful, this project will provide patients and health care providers with an unintrusive and more accurate tool for real-time monitoring of typical compulsive behaviors in order to appreciably improve the efficacy of front-line treatments for OCD.